When a horse suffers a fracture or develops disease in a cheek tooth, a veterinarian may need to extract it if conservative treatment—such as endodontic treatment to remove infected, injured, or diseased pulp from a tooth’s root system—is not an option. . Equine veterinary dentists can choose from a number of tooth extraction methods, depending on the condition of the tooth.
“These tooth extraction procedures involve the standard oral extraction technique, which should always be preferred over other more invasive techniques,” said Alexis Leps, DVM, Dipl. EVDC Eq, of the Faculty of Veterinary Medicine in the Department of Large Animal Surgery, Anesthesiology and Orthopaedics, Ghent University, Merelbeke, Belgium. He said they also include methods such as:
- Partial crownectomy (partial removal of the crown to facilitate extraction) to promote tooth dislocation (disruption of the ligament that holds the tooth in its socket).
- Minimally invasive transoral screw extraction (accessing the oral cavity through a cannula inserted into the horse’s cheek, allowing a screw to be placed in the tooth through this cannula).
- Repulsion (removal by pushing the tooth out of the root into the mouth). and
- Section.
What is a dental incision in horses?
When a horse breaks a tooth and there is no clinical crown (the visible part of the tooth) to grasp with forceps for extraction, or it is too decayed for minimally invasive extraction through the cheek, veterinarians can use a dental incision, Leps said. During this procedure, a veterinarian cuts the tooth into three pieces and lifts and removes each piece one by one, including the tooth root.
A study of the advantages of dental incision in horses
“In our retrospective study (using data from previous surgeries), we described extraction of cheek teeth with the incisional technique, the decision-making process that led dentists to use this technique, and potential complications,” Leps said. “However, dental incision is still considered an alternative technique and we wanted to investigate the prevalence of this surgical procedure in our study sample.”
Leps and his fellow researchers analyzed clinical records of all equine tooth extractions performed at his department at Ghent University between October 2020 and July 2023. They recorded 29 (6.3%) of the 461 teeth in the study requiring extraction of teeth through a dental incision, which he said is too low.
“As with any surgery, dental extractions in horses should be as minimally invasive as possible,” Leps said. “This means we always try to cause as little collateral damage to the surrounding tissue and anatomical structures as possible.”
In selected cases in modern dentistry, the non-invasive tooth cutting technique has already replaced the repulsion technique, Leps said. “By not damaging the surrounding tissues, the postoperative complication rate remains low (about 13%), where retraction of teeth by drilling through a bony hole has a reported complication rate of 40 to 60% according to studies of this the issue’, extending recovery time.
The complication rate was low in the case series analyzed, Leps said, but he emphasized the need for meticulous control of the incision procedure. It also requires fully cooperative patients, which is not always the case.
Take-Home Message
Cutting teeth in horses is a practical and less invasive alternative for dental extractions when standard extraction methods are not possible, Leps said. He and his colleagues found that practitioners often choose an extraction technique based on case-specific details from clinical oral examinations and medical imaging. Therefore, equine veterinarians should consider this procedure on a case-by-case basis.
